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Tuesday, December 23, 2008

Mary Pitt: "A New Wind Blowing"

The whole country is agog with the news of the Madoff Ponzi scheme and the billions he scammed from big investors, but nobody appears to realize that it is only the tip of a huge iceberg. There are other so-called legitimate institutions afloat in the private sector that are profiting from similar scams with the heartfelt approval of the raging capitalists in government as well as private individuals.

Foremost among these are the insurance companies as they have become established in America. Even the government social programs such as Medicare and Medicaid are administered by the accounting departments of insurance companies. The regulations regarding these programs were written in large part by the insurance companies and, as the result, even the very poor are not getting the services they need under their provisions.

Look at the case of a lady I will call Suzy, a middle-aged lady who, though mentally retarded, had worked as a bus person in a hospital cafeteria until her vision deteriorated so badly that she became qualified for Social Security Disability Support. Since she was not yet 65 years old, she was not initially eligible for Medicare and so became dependent on Medicaid for two years for her health care. At the age of forty years, she was found to have serious heart trouble and required a quadruple bypass surgery. Then she required a medical regimen that would last for all her life. Among the many medications upon which her life depended was the blood thinner, Coumadin, a patented and quite expensive tablet. She thrived amazingly well and recovered nicely.

Though her vision was her "primary disability", the coverage provided for her eyes was minimal and she struggled to pay for the necessary replacement of her lenses as that condition continued to progress. Eventually, a surgerical procedure was developed which would help to recover a portion of her vision. She had become eligible for Medicare and the surgery was covered but the new lenses were something that she had to pay for herself from her limited income. Gone were the "Coke-bottle" glasses due to the addition of the implanted lenses. She could stop practicing with the white cane and see well enough to be able to cross a street without assistance.

Then Medicare Part D was instituted and she had to look to an insurance company for the medications. This became a near disaster which was to threaten her life. The insurance company would pay only for generic medications and so she had to exchange the highly successful regimen of Coumadin for the generic Warfarin, commonly known for its primary use as a rat poison. As her pharmacist later explaind, Warfarin is not "dosage stable", meaning that the strength is known to vary from batch to batch and she was receiving a "bad batch"!

She became covered with black-and-blue patches as the capillaries leaked under her skin and a medical examination disclosed the fact that she was also bleeding internally.

The Warfarin dosage was adjusted but, as she improved, she still complained of "floaties" in her vision. The ophthalmological surgeons found that she had bled inside her eyes and the "floaties" were specks of blood and it would take time for them to resorb. Eventually this occurred.

However, the implanted lenses had become permanently clouded and so a second surgery was necessary to replace them, and of course, new glasses were necessary since there was additional permanent damage to her vision. It makes one wonder whether the money saved by "buying generics" was equal to the cost of the second surgery and the after-care, not to mention the added suffering of the patient and the sacrifices for her to have to pay for the second pair of glasses.

This is typical of the quality of care that is provided by Medicare, which is merely a copy of the insurance company standards. The health of the patient takes a back seat to the pennies which are saved by the mandatory desgination of which meds are covered. Suzy is not an anomaly but merely an example of the many shortcomings that are occuring on a daily basis. None of the plans are adequate to the needs. Mothers of young children who become ill are forced to wait until they have the money for the "co-payment" before taking them to the doctor. People who have survived surgery for life-threatening conditions are forced to delay or cancel appointments for after-care because they cannot afford the co-payments. The result is that they wait and become more ill, requiring more care than if they had been able to have their care directed by their physician rather than by an insurance clerk or by their need to pay their rent and utilities.

On the other hand, the insurance companies become more prosperous and even more greedy, They live by the bottom line, some even consolidating into "investment groups" that can later be saved from their own folly by government bailouts. One company had a CEO who embezzled a couple of million dollars but the newspapers have not carried a story about his punishment, if any. Perhaps they consider that the loss of his cushy, high-dollar job was sufficient. They live in an entirely different world from those for whose health they have assumed responsibility and about whose welfare they couldn't care less. It's all about the bottom line to them.

Now we are promised "change" which will "reform" the health care system. What we see discussed is a further subsidy to insurance companies or a plan to "assist" poor people in the payment of their premiums, all of which will only aggravate the problem. Even the computerizing of all medical records and the facilitation of their more rapid sharing willl not cut much from the cost of health care delivery. It is only by the removal of power over our most personal care from the hands of the money-grubbing "private enterprise" that this can be accomplished. It is not "socialist" to propose a single-payer plan. The government would not own the hospitals and doctors would not be government employees. They would continue to do business as usual and they and the patients would still make decisions as to the necessary care and procedures. And they would save money by being able to follow a simpler billing procedure.

As the old war-protest song told us, "The answer is written in the wind". There is no way to remedy the problem of public health and its burgeoning costs other than to accept it as a public problem. The cost of health care is threatening all of America's industrial base, though the workers have the ever-increasing premiums withheld from their paychecks in varying percentages and still must cope with the omni-present "deductibles and co-payments".

If the same amounts were withheld and paid into a public fund, health care would improve and the cost could be contained. Even those who presently carry individual health insurance would find the costs to be even less than they are currently paying. Physicians' costs would drop due to the lack of necessity to bill various companies and to comply with the pertinent and diverse forms and regulations of those companies. And, incidentally, the corporations would be relieved of the burgeoning costs of providing health care for employees and retirees.

A wise man, Henry Kaiser, once said, "It costs less to keep people healthy than to make them well." It is time for us, as a nation, to recognize that wisdom and to turn our attention to the provision of all types of health care to all our citizens, not just those who can afford to carry insurance or have the few dollars in their pockets to get past the front desk to obtain the care that they need. The dyed-in-the-wool capitalists will bellow that we would be killing the insurance companies. We can only reply that they are killing us, may they rest in peace. Our out-going President touts "responsibility" and indicates that "it is every man for himself". We see no acceptance of responsibility from the insurance companies and we are determined to defend ourselves from the many-tentacled monster that has us by the throat.

The citizens of the United States need universal health care and they need it now. What they do NOT need is yet another éommission" of very important people who will sit around for a year or two listening to lectures and instruction by a crew of insurance company officials and announce at last another plan to lubricate those same insurance companies with more of the taxpayers' money. The predictable result would be to throw still more stumbling blocks between the American citizen and his physician.

We must allow the new wind to blow away the cobwebs of complacency and allow our leaders to consider the common sense in moving health care from the profit-making industries and place it where it belongs, in the hands of the health care professionals and the scientific community. Only witth a realistic assessment from this point of view can we understand and find the best answer to the problem. We must allow no more low-income workers to fall through the huge cracks in our medical system and no more children to depend on the skillful manipulation of the family budge to provide the care that they need. No more must our elderly be required to subsist on meager rations in order to pay for their medications, becoming ever more frail as they march to a hospice. Only when these problems are faced head-on can the American Dream get back on the road to reality.

We have a nation that must be rebuilt; we have a democracy to be set back on the right track; we have a national debt that will be with us for generations, and an economy that is depleted of resources. This cannot be accomplished by a nation of ill, handicapped people with neglected children and working adults who are needlessly worried about the welfare of their families. For our nation and our own future, we must correct this situation and we must do it now.

The author is a very "with-it" old lady who aspires to bring a bit of truth, justice, and common sense to a nation that has lost touch with its humanity in the search for "societal perfection".

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